钉合与缝合技术应用于骨科脊柱手术切口中的疗效比较

摘要

目的：比较钉合与缝合技术应用于骨科脊柱手术切口中的疗效观察，探讨一次性皮肤缝合器在骨科骨科脊柱皮肤切口中的应用价值。方法选择150例骨科脊柱手术患者，随机分为两组，治疗组75例，术中采用一次性皮肤缝合器缝合切口，对照组75例采用常规丝线缝合切口。分别对两种缝合方法在切口感染、切口裂开、炎性反应（红肿）、分泌物、坏死、过敏反应、术后3个月切口"蜈蚣症"的发生率，缝合速度，拆线（钉）时的疼痛程度，9项指标进行统计学分析。结果两组在缝合速度，钉（线）道炎性反应发生率，拆线（钉）时的疼痛程度，术后3个月切口"蜈蚣症"的发生率方面差异显著（P<0.01），治疗组在拆钉时比对照组拆线时有较高的疼痛程度；有较高的钉道炎性反应（表现为钉道红肿）发生率；但有更快的缝合速度；术后3个月随访，切口瘢痕"蜈蚣症"的发生率为0%，对照组为24.00%；两组在切口感染、切口裂开、炎性反应（红肿）、分泌物、坏死、过敏反应方面无显著差异。结论钉合技术（一次性皮肤缝合器）相对于缝合技术（常规丝线）在缝合骨科脊柱皮肤切口有更快的缝合速度及更好的美容效果，但有较高的钉道炎性反应（表现为钉道红肿）发生率，因此不推荐将钉合技术应用于缝合骨科脊柱皮肤切口。%Objective: To compare stapling and suturing technique used in orthopedic spinal surgery incision ef icacy, To explore the application value of disposable skin closure in orthopedic spinal incision of the skin incision. Methods: 150 cases of patients with wrist hand ankle foot parts of the surgery, were randomly divided into treatment group 75 cases using a disposable skin stapler, 75 cases of the control group using conventional suture the incision. The incision infection, wound dehiscence, inflammation (swel ing), secretions, necrosis, al ergic reactions, 3 months after the incision centipede disease incidence, stitching speed, the degree of pain stitching, nine indicators were statistical y analyzed. Results: there were significantly dif erent in The degree of pain,inflammation incidence,centipede disease incidence and the speed of stitching(P<0.01),the treatment group have a higher degree of pain;faster suture;a higher inflammation ( swel ing ) reactions .the centipede disease incidence was 0%after the fol ow-up,however,it was 24.00% in the control group; two groups were no significant dif erences in the incidence of infection, dehiscence, secretions, necrosis, al ergic reactions. Conclusion:stapling technique ( disposable skin stapler ) relative to the suture technique ( conventional silk ) in orthopedic spine skin incision suture has a faster speed and bet er cosmetic suture ef ect, but there is a higher screw channel inflammatory response ( performance of pin tract irritation ) incidence , therefore , it was not recommended that stapling technique used in orthopedic spinal surgery incision.